Take control of your health through personal genetic profiling, writes Kasmiah Mustapha

Your DNA may determine the best food to eat. Styling and photography by Amir A

YOU and your friend have been on the same diet for months. While she is losing weight, you are putting on the kilos despite following every step consistently.

It turns out that your genes are the determinant factor. Two people can be on the same diet but due to their genetic makeup, their bodies will respond differently.

In 2003, the Human Genome Project identified between 20,000 and 25,000 genes and determined the sequence of the three billion chemical base pairs of the human genome. Of these base pairs, 97 to 99 per cent is identical among any two given individuals. Which means, the fundamental processes of food metabolism in every human body are largely the same.

However, the one to three per cent genome difference in some people makes them respond differently to the different types of food.

In recent years, researchers are looking into nutrigenomics, a study on how genes and nutrients interact at the molecular level. The study revealed that a person’s genetic make-up determine which nutrients are beneficial or otherwise to their body.

Beacon Laureate nutrigenomics practitioner Cheong Yuen Khai says that for some people, weight management may not be as simple as calorie in and calorie out. The “one-size-fits-all” diet does not apply to those who may have genetic variants that make it hard to lose weight.

“The balanced meal guideline is probably applicable to some people but it may not work for others. For these people, dietary pattern that suits their genes is better at helping them managing their weight and health.

“We cannot change our genetic makeup, but technology now has given us the choice to understand them and find ways to modify our lifestyle in favour of our genes. With genetic profile, you can repair DNA damage and improve the functioning of your genes by making the right nutrition, exercise and lifestyle choices.

“Knowing how the person’s genes interact with food allows him to go on a diet that fits his DNA. It can bring better outcome compared to following the common weight loss programmes.”

People with variants on gene CYP1A2 are slow metabolisers of coffee, putting them at greater risk for high blood pressure or a heart attack when caffeine intake is high. Pix courtesy of alzdiscovery.org

GENES VARIANTS

Cheong says there are genes that have been identified to have direct or indirect effect on weight gain — FAB (fat absorption), PPARγ, PPARgC1A (fat storage) and LEPR-1, LEPR-2, FTO and MC4R (appetite control).

“A person with variant genes on this panel is at higher risk of food cravings and preference especially for fatty foods, carbohydrates and energy dense foods.

“For example, if he has a variant fat absorption genes, he would absorb twice the amount of fat, making him more susceptible to weight gain. Similarly if someone has unfavourable appetite control genes, he eats more.

“When the person has these variants, he needs to be more cautious about the quantity and the type of food intake and to put in more effort in exercising to manage his weight.”

“For example, the gene PPAR-y is a hormone receptor linked to obesity. Coupled with living in an obesogenic environment, the person can be at higher risk of being obese and may need lower energy intake to keep weight stable.”

“However, your genes does not mean you are predisposed to a certain conditions. A person with genes that predisposed him to weight gain does not mean he will become obese. He needs to be more aware of his diet and exercise to control his condition. This is when the genetic profiling helps.”

PERSONALISED DIET PLAN

Loh says there is a team of doctors, dietitians and nutrigenomics practitioners to assist in planning personalised healthcare interventions. The dietary pattern recommended is based on the latest nutritional guidelines and evidence-based practice.

She says her role is to integrate food and nutrition knowledge into practice, making sure it is precise and based on the clients’ needs, readiness to change, and socioeconomic factors.

“I have recommended healthy balanced diet for vegetarians, low fat diet, carbohydrate counting for diabetes and low purine diet for people suffering from gout. It is also important to consider the person’s tradition, religion, culture and personal food preferences.”

“The DNA panels also discuss about the positive effects of exercises. Some genes work better with aerobic exercises, strength training or high-intensity training so we will recommend the types of exercises as well.”

Although the person is following dietary pattern that suits his genes, it does not mean the effect can be seen immediately.

“A diet can be precise, but it can never be perfect. There is no fixed timeline as to when one can see results because the interventions recommended are for long term changes. The expected improvement should be slow but sustainable, and ultimately the individual can manage his or her health goals with confidence.

“Some people may be ready to change and others may not. This is where the challenge lies, and nutrition interventions can either work very well or not at all.”

Loh says a person can rarely follow the same dietary recommendations for life as his needs change according to life stages, changes in physical activity and medical condition.

“That means at different points in life, there will be changes to dietary recommendations as well. That is why I always advocate the importance of following up with a dietitian or healthcare professional to reassess your nutritional needs.”

Cheong says while diet alone may not be able to prevent diseases, it is an important factor that can directly or indirectly contribute to disease progression.

“For example, low fibre diet and high red meat intake are known risk factors of colorectal cancer. Diet also plays a role in type 2 diabetes and hypertension. Because over a period of time, uncontrolled carbohydrates and salt intake could heighten the risk.

“Of course, other factors such as stressors in life, family history, sedentary lifestyles can also increase the risk of these chronic diseases.”

Genetic profiling

PERSONALISED genetic profiling offers an insight into how our body responds to diet, nutrition, exercise and lifestyle. Based on the science of nutrigenomics, Fitgenes Australia interprets the results to create a personalised intervention for better health outcome.

Co-founder and chief scientific officer Paul Beaver talks about the interaction between genes and nutrition and the effect on weight management.

People can be on the same diet but due to their genetic makeup, the results are different. Styling and photography by Amir A

WHY IS THE INTEREST ON NUTRIGENOMICS?

People realise now that the current “one-size-fits-all” approach to improving health and well-being is not working. For example, some people lose weight on certain diets and yet for others, it has no effect or they can even gain weight.

Now, people are consuming more energy-dense foods, exercise less, are more stressed and consume more alcohol and drugs. Research has shown that 70 per cent of body weight is due to genetic while 30 per cent is lifestyle and environmental.

Our genes can determine our response to food, exercise and lifestyle choices, and consequently can have a major impact on health, such as weight management and the risk of obesity.

HOW DOES PERSONALISED HEALTHCARE HELP PEOPLE?

Personalised healthcare is a broad term that includes nutrigenetics, nutrigenomics and other physiological information. The combination can assist in the prediction of disease risk, dietary, nutritional and lifestyle choices and the impact on our health at a cellular level.

The fact is that our life expectancy is now longer than it has ever been and yet the number of years we live in good health (health expectancy) is significantly decreasing. We believe that people want to be treated as individuals by their healthcare providers and enjoy a quality of life that enables and even empowers them to maximise their potential for healthy living and healthy ageing.

WHO BENEFITS FROM GENOME-BASED PERSONALISED HEALTHCARE?

Anyone who wants to enjoy longer health expectancy throughout their life can benefit from personalised genetic profiling and a nutrigenomic approach to their healthcare.

I believe we were all designed to have a long and healthy life if we make nutritional, exercise and lifestyle choices based on our unique genetic profile. This is essentially our blueprint or roadmap for healthy living and healthy ageing. This is why nutrigenomics is the foundation upon which any personalised healthcare system must be built.

WHAT IS THE IMPACT OF GOOD AND BAD GENES ON OUR HEALTH?

Personally, I don’t believe in the so-called “good genes” and “bad genes” as our genes determine our uniqueness. I know there are some single genes associated with specific diseases, however these are only one or two per cent of all our genes.

It’s true we can’t change our genes but we can compensate for the influence of a large percentage of them by making the right nutritional, exercise and lifestyle choices based on our unique personal genetic profile.

Many of our genes act in a similar way to a light “dimmer switch”, in that they can be effectively “dialled up” or “dialled down” as required depending on the food we eat and our lifestyle choices. I like the saying that, every time we come to the dinner table we bring, not only our appetite, but also our genes.

WITH THE INCREASE IN CHILDHOOD OBESITY, WILL GENETIC PROFILING WORKS FOR CHILDREN?

I believe we can use nutrigenomics to understand obesity and type 2 diabetes, especially in children around 8 years old.

Individuals who have a variation in the FTO gene find it difficult to manage weight and blood sugar levels, especially if they lead a sedentary lifestyle.

Variations in this gene are adversely affected by high carbohydrate and low protein intake in our diets and lack of exercise for extended periods of time that are associated with an increased risk of obesity and type 2 diabetes.

Fortunately, interventions for children and individuals with variations in this gene are relatively easy. For example, undertaking a moderate level of exercise, such as walking, at levels recommended along with a reduction in carbohydrate intake and an increase in protein intake can have significantly positive effect on this gene.